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breast cancer

PI3K Inhibition in Hormone Receptor–Positive Breast Cancer ‘Not Ready for Prime Time’

Interest is high in studying the PI3K pathway in hormone receptor–positive breast cancer, but it is not clear which of the PI3K inhibitors under development—if any—will be a “home run.” The phase II FERGI study, reported at the 2014 San Antonio Breast Cancer Symposium, failed to meet its primary...

Expert Point of View: Hagan Kennecke, MD, Pamela L. Kunz, MD, and George Fisher, MD, PhD

Hagan Kennecke, MD, Associate Professor, University of British Columbia at the British Columbia Cancer Agency, said in an interview, “It was important to see the detailed subgroup analysis for pancreatic neuroendocrine tumors, because that is a major patient population we treat, and it was not...

Expert Point of View: Jaffer A. Ajani, MD

Jaffer A. Ajani, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, discussed the two studies. He emphasized the impressive cytoreductive activity of AMG 337. “Granted, it was only 13 patients, but in 13 patients, 8 [responders] is a...

gastroesophageal cancer

Inhibiting the MET Pathway in Gastroesophageal Cancer: Hits and Misses

The MET pathway appears to be important in gastroesophageal cancers, but response to a targeted agent may depend on the class of drugs. A robust response to the novel small-molecule MET inhibitor AMG 337 was observed, but a monoclonal antibody targeting MET fell flat, in studies reported at the...

colorectal cancer
pancreatic cancer
gastrointestinal cancer

New Data Reported in Colorectal, Gastric, and Pancreatic Cancers

The 2015 Gastrointestinal Cancers Symposium, held January 15–17 in San Francisco, attracted almost 4,000 attendees, who heard or viewed data from nearly 800 scientific abstracts and lectures. Here are our summaries of some of the many important developments from the meeting. Bevacizumab Plus...

global cancer care

Addressing the Global Cancer Burden

Since 1990, the annual global death toll from cancer has risen about 40%, and that number is projected to increase from the current level of approximately 8 million cancer deaths per year to more than 13 million by 2030. The poorer, resource-challenged regions of the world will suffer a...

issues in oncology

Big Data and the Promise of Precision Medicine in Cancer

Precision medicine—and its promise to revolutionize how we understand disease and care for our patients—is a concept that oncology has understood and embraced for well over a decade. But millions of Americans recently heard about the concept for the first time when President Obama announced a...

breast cancer

Nearly Half of Women Taking Tamoxifen for Primary Prevention Discontinue Its Use Before 5 Years

After 4.5 years of taking tamoxifen for primary prevention of breast cancer, 46% of women discontinued its use, according to research conducted within the Sister Study, a prospective cohort of women who had a sister diagnosed with breast cancer but did not have breast cancer themselves. Eligible...

palliative care

Caregivers May Want to Know About a Patient’s Impending Death but May Be Afraid to Ask

The likelihood of impending death of patients with advanced cancer “is one of those questions that many people want to know about, but they are too afraid to ask,” David Hui, MD, MSc, said in an interview with The ASCO Post. Dr. Hui is lead author of a study, published in Cancer, on clinical signs...

palliative care

Recognizing Physical Signs Associated With Impending Death Can Assist Clinicians, Patients, and Caregivers With Complex Decisions

In a recently published study of patients with advanced cancer whose status was systematically documented twice a day, from the time of admission to a palliative care unit until death or discharge, investigators identified eight physical signs associated with death within 3 days. Taken together...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

cns cancers

Having Cancer So Early in Life Gave Me Purpose

I had every classic brain tumor symptom in the book—severe headaches, dizziness, morning nausea—which plagued me for 16 years, starting when I was 8. In college, if I allowed myself to sleep more than 4 hours a night, the morning headaches, which were centered on the top of my head, were so severe, ...

head and neck cancer

The Center of Who We Are

The following essay by Eric M. Genden, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org.   There’s...

Harold Varmus, MD, Steps Down as NCI Director, Douglas Lowy, MD, Named Acting Director

Harold Varmus, MD, who has led the National Cancer Institute (NCI) at the National Institutes of Health (NIH) for nearly 5 years, has announced that he will step down from his post, effective March 31, 2015. “It has been our great fortune to have Dr. Varmus at the helm of the NCI,” said NIH...

breast cancer

Dr. Halsted’s Breast Amputation Specimens, Johns Hopkins Hospital, 1894

A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the late 1800s and showcase the early medical advances and treatments in cancer. The images and captions are excerpted from a four-volume series of books titled ...

survivorship
breast cancer

Mobile Patient-Centered App Tracks Breast Cancer Survivors’ Experiences

Patricia Ganz, MD, Director of Cancer Prevention and Control Research at the Jonsson Cancer Center of UCLA, and collaborators Apple and Sage Bionetworks, recently announced the launch of “Share the Journey: Mind, Body and Wellness after Breast Cancer,” a patient-centered mobile application (app)...

issues in oncology

Study Finds Websites That Market Personalized Cancer Care Services Overemphasize Benefits

A recent analysis of 55 Internet websites marketing a broad range of tests and services that promise the ability to personalize cancer treatment has found that the websites often overemphasize their purported benefits and downplay their limitations. In addition, the study results show that the...

integrative oncology

Herbal Supplements: Increasing Problems

In Don Quixote, the 1605 Spanish literary masterpiece by Miguel Cervantes, “Balsam of Fierabras” is mentioned often as a therapeutic panacea. It calls for mixing rosemary, wine, oil, and salt. As the story goes, the knight relied heavily on this herbal preparation to relieve him of pain from the...

breast cancer

Wrestling With the Challenges of Breast Cancer

Bookmark Title: Then Came Life: Living With Courage, Spirit, and Gratitude After Breast CancerAuthor: Geralyn LucasPublisher: Gotham BooksPublication date: October 2, 2014Price: $19.89; hardcover, 240 pages Over the past decade or so, the oncology community has increased its understanding and...

health-care policy
cost of care

Medicine Turned Upside Down

BookmarkTitle: The Patient Will See You Now: The Future of Medicine Is in Your HandsAuthor: Eric Topol, MDPublisher: Basic BooksPublication date: January 2015Price: $28.99; hardcover, 384 pagesMost books about health care center on fixing broken parts of the massive $3 trillion system, as seen with ...

lymphoma

New Partnership Launches to Empower People Diagnosed With Lymphoma

The Leukemia & Lymphoma Society (LLS), together with the Lymphoma Research Foundation (LRF), CancerCare, the Association of Community Cancer Centers (ACCC), and Genentech announced the launch of a new partnership, the Alliance for Resource Collaboration in Hematology (ARCH). ARCH was developed...

multiple myeloma

Five Questions Can Guide the Treatment of Relapsed Myeloma

Joseph Mikhael, MD, MEd, myeloma expert at the Mayo Clinic in Arizona, Scottsdale, and Associate Dean of the Mayo School of Graduate Medical Education, considers five questions when selecting treatment for patients with multiple myeloma who relapse. “With prolonged survival, which approaches 10...

issues in oncology

Avoiding Burnout and Maintaining Well-Being While Caring for Seriously Ill Patients

A variety of studies, including one published this past year in the Journal of Clinical Oncology,1 have showed that clinicians who care for seriously ill patients are at high risk for diminished personal well-being, including high rates of burnout; moral distress, defined as the inability to act in ...

ASCO Expresses Concern Over New Oncology Care Model

While commending the Centers for Medicare & Medicaid Services (CMS) for seeking new approaches to physician payment, ASCO expressed concerns over the model’s limited scope. “We are disappointed [CMS has] chosen to pursue only one model—and one that continues to rely on a broken fee-for-service...

palliative care

Helping Patients Understand Palliative Care

The booklet Palliative Care: Improving Quality of Life for Patients and Families is one of the latest additions to the ASCO Answers collection of patient education materials developed by ASCO for people with cancer and their caregivers. These materials provide oncologist-approved information in a...

Beating the Odds in The Big Casino

More than 35 ASCO members contributed personal essays to a recently published collection of stories about humanism in medicine, including ASCO Past Presidents Paul A. Bunn, Jr, MD, FASCO, and Emil J. Freireich, MD, FASCO, and current President-Elect Julie M. Vose, MD, MBA, FASCO. The Big Casino:...

FDA Takes Steps to Simplify Compassionate Use Process, Invites Comment

The U.S. Food and Drug Administration (FDA) introduced a more streamlined form for requesting permission for patient access to investigational drugs outside of clinical trials. The new form is available for comment in a draft guidance for industry entitled “Individual Patient Expanded Access...

2015 Pre–Annual Meeting Seminars Feature Important Topics for Modern Cancer Care Providers

ASCO will once again be offering a series of Pre–Annual Meeting Seminars ahead of its 2015 Annual Meeting in Chicago. First offered in 2012, the Pre–Annual Meeting Seminars are a series of in-depth educational opportunities dedicated to topics of interest in the oncology community. The seminars are ...

multiple myeloma

Panobinostat in Combination With Bortezomib‑Dexamethasone in Previously Treated Multiple Myeloma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On February 23, 2015, panobinostat (Farydak) was granted...

issues in oncology

Development and Approval of Biosimilar Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, Leah Christl, PhD, and Albert Deisseroth, MD, PhD, answer questions about biosimilar products. Dr. Christl is the Associate Director...

issues in oncology

New Lurie Cancer Center Program Combines Oncology  With Genomics to Provide More Personalized Cancer Care

The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, in collaboration with the Northwestern Medicine Developmental Therapeutics Institute and Northwestern Memorial Hospital, has launched a new research program, Northwestern Onco-SET (Sequence, Evaluate, Treat). The program’s...

multiple myeloma

Lenalidomide in Combination With Dexamethasone in Newly Diagnosed Multiple Myeloma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On February 18, 2015, the indication for lenalidomide (Revlimid)...

issues in oncology
health-care policy

Ongoing Controversies in Allocating Our Health‑Care Resources

Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care...

issues in oncology

Physician-Controlled Decisions in Cancer Care Linked to Lower Quality Rating

Patients who described physician-controlled decisions about their cancer care vs shared decision-making were less likely to report receiving excellent quality of care, according to a study published by JAMA Oncology.1 The Institute of Medicine has called for shared decision-making and accommodation ...

breast cancer

SOFT Trial Results Inconclusive: Further Study Needed

The results of the SOFT trial—presented at the 2014 San Antonio Breast Cancer Symposium, reported recently by Francis et al in The New England Journal of Medicine,1 and reviewed in this issue of The ASCO Post—were not as conclusive as we had hoped. In essence, the study enrolled women with resected ...

breast cancer

Adjuvant Ovarian Suppression May Benefit Women With Premenopausal Breast Cancer Who Received Prior Chemotherapy

In a phase III trial (SOFT) reported in The New England Journal of Medicine, Prudence A. Francis, MD, of Peter MacCallum Cancer Centre, Melbourne, Australia, Meredith M. Regan, ScD, of IBCSG Statistical Centre at Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of...

breast cancer

Increasing the Use of Hypofractionated Radiation in Early-Stage Breast Cancer: The Way Forward

Bekelman and colleagues are to be congratulated on the publication of an important paper—reviewed in this issue of The ASCO Post—alerting us all to the underutilization of hypofractionated whole-breast irradiation in the treatment of early-stage breast cancer.1 As background, recent randomized...

Expert Point of View: Nancy Kemeny, MD

Nancy Kemeny, MD, Attending Physician at Memorial Sloan Kettering Cancer Center and Professor of Medicine at Weill Cornell Medical College, New York, discussed the study at the session and noted several limitations: The data could be outdated (chemotherapy and surgery could be better now), some...

colorectal cancer

Optimal Timing of Rectal Surgery: 60 Days or Less Post Chemoradiation Therapy

For the treatment of locally advanced rectal cancer, the optimal timing between the end of neoadjuvant chemoradiation therapy and surgical resection appears to be 60 days, according to an analysis of the National Cancer Database presented at the 2015 Gastrointestinal Cancers Symposium.1 An interval ...

supportive care

Many Cancer Patients at Risk for Hepatitis B Virus Reactivation

In 2015, no cancer patients should be cured of their malignancy only to die of reactivation of hepatitis B virus (HBV),” according to Anna S. Lok, MD, the Alice Lohrman Andrews Research Professor in Hepatology and Director of Clinical Hepatology at the University of Michigan, Ann Arbor. “I...

AACR Names Nancy E. Davidson, MD, President-Elect for 2015–2016

The American Association for Cancer Research (AACR) has announced the election of Nancy E. Davidson, MD, Director of the University of Pittsburgh Cancer Institute and UPMC CancerCenter in Pittsburgh, as its President-Elect for 2015–2016. Dr. Davidson will officially become President-Elect at the...

Expert Point of View: Matthew I. Milowsky, MD

Commenting on the study presented by Galsky et al at the Genitourinary Cancers Symposium, Matthew I. Milowsky, MD, Section Chief, Genitourinary Cancer, at the Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, agreed with Dr. Galsky that it is unlikely that we will...

bladder cancer

Adjuvant Chemotherapy Favored in Locally Advanced Bladder Cancer Not Treated With Neoadjuvant Therapy

A large observational study presented at the 2015 Genitourinary Cancers Symposium in Orlando, Florida, found that adjuvant chemotherapy extended the likelihood of survival in locally advanced bladder cancer compared with observation alone.1 Using three different approaches to propensity scores...

bladder cancer

Antiangiogenesis Plus Chemotherapy Pursued in Advanced Bladder Cancer

Two separate phase II studies lend support to the concept of antiangiogenesis in advanced bladder cancer. The combination of an antiangiogenic agent and chemotherapy may fulfill an unmet need in this disease, the studies suggest. Both studies were presented at the 2015 Genitourinary Cancers...

prostate cancer

High-Dose Radiotherapy Provides Meaningful Improvements in Localized Prostate Cancer—But Not Increased Survival Yet

High-dose radiotherapy failed to improve overall survival at 7 years compared with standard-dose radiotherapy in men with stage II localized prostate cancer. However, the high-dose schedule had several advantages, including improved rates of local tumor control and distant metastasis, according to...

triple-negative

Our Aging Population: Challenges in Caring for Older Patients With Cancer

Managing older-aged cancer patients represents one of the major challenges to our health-care system. Caring for older cancer patients, with their frequent multiple morbidities and a variable health status, requires special integration of an oncologic and geriatric approach. Moreover, our aging...

issues in oncology
health-care policy

Health-Care Fraud and Abuse: Implications for Oncology

Health-care fraud is a long-standing problem in the United States, accounting for $75 billion in government expenses per year,1 while total spending on government health-care programs is over $1 trillion. Two decades ago, the Department of Justice increased its efforts to combat health-care fraud....

Expert Point of View: Charles Ryan, MD

ASCO Expert and GU News Planning Team Member, Charles Ryan, MD, of the University of California, San Franciso, Helen Diller Family Comprehensive Cancer Center, said the results presented by Singh et al at the 2015 Genitourinary Cancers Symposium were “encouraging” and that it makes sense to exploit ...

prostate cancer

Intensified Immunotherapy Encouraging in Chemotherapy-Naive Metastatic Prostate Cancer

Emerging evidence suggests that immunotherapy may play an important role in treating prostate cancer. In particular, preliminary results have shown that combining a new vaccine with ipilimumab ­(Yervoy) boosts overall survival in men with castration-resistant prostate cancer.1 A study comparing...

Remembering Neurosurgeon and Writer Paul Kalanithi, MD

What initially drew me to read the eloquent essay by Paul Kalanithi, MD, in The New York Times—“How Long Have I Got Left?”—was its provocative title.1 What kept me there was the moving description of his quick transition from healthy physician with a brilliant career in neurosurgery to terminally...

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